Choking at night is a very worrying complaint, which can be a manifestation of heart or lung disease. Patients very painfully suffer this symptom, since it takes them by surprise during sleep, and in a number of cases there is no one nearby who could help or support, which further worsens the situation by terrifying people and giving them a sense of helplessness and insecurity.
To fall asleep after such an attack is not always possible, because the patient is afraid of a second attack. But not always the night suffocation is a sign of the disease, often patients with an overexcited nervous system experience exactly the same symptoms, while there is no real danger to their life. Therefore, in this article I would like to draw a line between a dangerous and non-dangerous choking at night.
Please note that here we will not talk about the choking that has arisen for the first time, but only about the choking, which from time to time repeats for a long time. Since the first occurrence of sudden asthma (even in the daytime) may be a sign of an acute disease requiring urgent treatment (heart attack, thromboembolism, pulmonary edema, asthmatic status, etc.).
So, to begin with, it should be said that in the vast majority of cases, the cause of a sudden attack of choking at night is heart disease, lung disease, or instability of the nervous system, including mental illness. Let's consider all possible states in order and discuss their distinctive features.
Night choking is a very characteristic symptom for people suffering from heart failure. As a rule, patients complain that it is hard for them to breathe air (there is a lack of it). Often this condition is accompanied by coughing, sweating.
Dyspnea decreases in sitting position and after taking diuretics, there can also be a positive effect after taking nitroglycerin. Such patients necessarily have some chronic heart disease - hypertensive or ischemic disease, problems with valves, etc.
Heart failure does not occur on level ground, therefore, people suffering from attacks of nocturnal asphyxia due to heart failure, necessarily identify changes with the heart during the examination. That is, it cannot be such that a person suffers from heart failure at night, and in the afternoon he (she) absolutely does not have any complaints and all indicators, including ECG, ultrasound and chest X-ray are normal.
Angina is primarily a pain of pressing or burning nature, which usually occurs behind the sternum. But sometimes angina is manifested not in the form of pain, but in the form of suffocation, the mechanism of which is associated with the development of acute, but short-term, heart failure. Such suffocation is difficult to distinguish from the one in chronic heart failure described earlier.
As a rule, patients suffering from episodes of nocturnal suffocation due to angina pectoris have similar symptoms in the daytime, especially under physical exertion, whereas in patients with heart failure there is no choking during the day, and there is only shortness of breath.
It is a disease of the lungs, which is expressed in a sudden spasm of the bronchi (airways), which leads to a sharp decrease in ventilation of the lungs and, consequently, a lack of oxygen in the blood.
Night attacks of asthma are quite common and, in contrast to "cardiac", they are accompanied by a feeling of incomplete exhalation (the air is hard to exhale, and not to inhale!). Patients have a feeling that there is a valve in the lungs that lets in, but does not let it back.
Nitroglycerin and diuretics in no way facilitate the patient's condition, only inhalers, for example, salbutamol, or intravenous steroids (hormones) help.
Diagnose asthma on the basis of complaints, family history and spirometric lung examination, as an option is prescribed salbutolol during an attack, if it brings relief, then the cause of this nocturnal asphyxia becomes more obvious.
Panic attack - sympathoadrenal crisis:
Many young people with unstable work of the nervous system (the so-called NDC or VSD) sometimes develop at night a feeling of choking. This, as a rule, is not even suffocation, but a sense of lack of air.
Such a state is accompanied by very vivid emotional experiences, and if patients with asthma and heart failure describe an attack in two or three words, then patients suffering from NCD except for suffocation feels dozens of additional complaints: dizziness, nausea, palpitation, indeterminate pain in the chest, fear, panic, trembling in the body, chills, sweating, etc. Certainly, patients with heart and lung disease may also experience these symptoms, but suffocation is what prevents them 100 times more than all other accompanying "Little things."
In patients with NDC, everything interferes at the same time and equally. The data of the studies do not reveal any abnormalities, and the age of such patients usually does not exceed 30-40 years. Most of them undergo examinations many times, go to different specialists, believing that they are deadly sick, and doctors do not understand this. In this group of patients, a good effect is achieved with sedatives, tranquilizers, antipsychotics, and even better - psycho-training. Usually people with such symptoms take medications on regular basis and it is better for them to find best rated online pharmacy.
From all of the above, we can say that in assessing chronic nocturnal asphyxiation, one should be guided by the principle "there is no smoke without fire". And if during the day the patient is completely "healthy" according to the results of the survey and consultations of narrow specialists, it is not worth "getting stuck", but it is worth trying to solve this problem with a psychotherapist or psychiatrist, especially since there will not be any harm from it. In conclusion, it should be canceled that this article, although written for patients, but is not a guide for diagnosis which is always decided by the doctor.